Five Stages of Grief
Kübler-Ross model describes, in five discrete stages, the process by
which people deal with grief and tragedy. Terminally ill patients are
said to experience these stages. The model was introduced by Elisabeth
Kübler-Ross in her 1969
book On Death and Dying. The stages have become well known, and are
called the Five Stages of Grief.
Enumeration of stages
The stages are:
Denial : The
initial stage: "It can't be happening."
Anger : "Why ME? It's not fair?!" (either referring to God,
oneself, or anybody perceived, rightly or wrongly, as "responsible")
- Bargaining : "Just let me live to
see my son graduate."
Depression : "I'm so sad, why bother with anything?"
- Acceptance : "It's going to be
Kübler-Ross originally applied these stages to
any form of catastrophic personal loss (job, income, freedom). This also
includes the death of a loved one and divorce. Kübler-Ross also claimed
these steps do not necessarily come in order, nor are they all
experienced by all patients, though she stated a person will always
experience at least two.
Others have noticed that any significant personal change can follow
these stages. For example, experienced criminal defense attorneys are
aware that defendants who are facing stiff sentences, yet have no
defenses or mitigating factors to lessen their sentences, often
experience the stages. Accordingly, they must get to the acceptance
stage before they are prepared to plead guilty.
Additionally, the change in circumstances does not always have to be a
negative one, just significant enough to cause a grief response to the
loss (Scire, 2007). Accepting a new work position, for example, causes
one to lose their routine, workplace friendships, familiar drive to
work, even customary lunch sources.
In popular culture these stages are almost
exclusively applied only to news of one's own impending death. The
notion that to resolve grief they must all be followed, in order, is
Although, in 1974, "The Handbook of Psychiatry" defined grief as "...the
normal response to the loss of a loved one by death," and response to
other kinds of losses were labeled "Pathological Depressive Reactions,"
this has become the predominant way for counselors and professionals to
approach grief, loss, tragedy and traumatic experiences.
Further, many psychiatrists believe real grieving begins after the
stages are over, and that "grief work", involving its own set of stages,
begins with acceptance, where the Kubler-Ross stages end.
Research on the theory
A February 2007 study of bereaved individuals,
from Yale University obtained some findings that were consistent with
the five-stage theory and others that were inconsistent with it .
The original Kübler-Ross model did not identify
five stages of grief. It identified what Kubler-Ross called "the Five
Stages of Receiving Catastrophic News". There exists no real evidence
that stages are present in coping with death: Using the terms stages
implies that there is a set order of set conditions, meaning that
everyone will go through each stage at the same time while confronting
impending death. The order of the stages, as well as the amount of time
each stage lasts can vary. Also, the definition of each stage is not
clear, and some stages can be combined.
More specifically, there is no real evidence that people coping with
their impending death move through all of the five stages. The path
through the stages is not a one-way street: they can repeat, occur out
of order or not at all. It is highly dependent on other qualities, such
as emotional ties to family, and other relationships. These stages can
also occur in a repetitive, spiral-like fashion where the individual is
re-working and re-experiencing various grief stages over time. "Real
events", such as moving, getting rid of the loved ones clothing or
objects, etc. tend to trigger a grief regression in which the grieving
individual may re-experience anger or shock or depression.
The way in which the particular loss is experienced may strongly
influence how grief is played out. A sudden loss or violent loss in
which one is "blind-sided", caught unaware and unprepared, may create a
traumatic loss which is probably more difficult to process and work